During the past year we have reported findings on smoking patterns, sleep disorders and cardiovascular disease in this study. We found an association between cigarette smoking and mood and anxiety disorders in female but not male smokers. We also showed that there was a U-shaped association between sleep duration and self-reported cardiovascular diseases (CVD) such that those with short sleep duration had a different set of biologic correlates of CVD including SBP, Non-HDL-cholesterol and UACR, heart attack, stroke, and any CVD, than those with long sleep duration who had higher values CRP and rates of stroke. Other analyses discriminated insomnia from non-restorative sleep on the basis of greater risk of CVD in the insomnia group, and primary sleep disorders, respiratory diseases, thyroid disease, cancer, and increased CRP in the non restorative sleep group. This suggests that these insomnia and non restorative sleep constitute two discrete subtypes of sleep disorders. Public Health Impact: These findings provided evidence from the general population that there are associations between sleep duration and CVD and biomarkers in U.S. adults, particularly in females. The sex difference was also evident between insomnia subtypes in terms of sociodemographics, comorbidity of other sleep and physical disorders, increased CRP level, and functional impairments;and the elevated risk of mood and anxiety disorder was observed among smokers and was more pronounced in female smokers than that in male smokers. These results comprise significant steps in understanding the biologic mechanisms, identifying more homogeneous subgroups in clinical and genetic studies, and developing better clinical management and population intervention program. Future Plans Future analyses of the NHANES data will aim to: 1) compare DSM-IV and DSM-5 definitions of ADHD and other disorders assessed in the study; 2) evaluate links between physical conditions and mental disorders; 3) examine the associations between sleep problems and biologic measures;and 4) investigate the pattern of psychotropic medication use among children and adolescents.

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U.S. National Institute of Mental Health
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Zhang, Jihui; Lamers, Femke; Hickie, Ian B et al. (2013) Differentiating nonrestorative sleep from nocturnal insomnia symptoms: demographic, clinical, inflammatory, and functional correlates. Sleep 36:671-9
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